Acute endovascular recanalization therapy in wake-up stroke
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Date
2011
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JOURNAL OF THE NEUROLOGICAL SCIENCES
Abstract
Background and Purpose: Up to 15-25% of patients with ischemic stroke wake up with their deficits. Because of the uncertainty about the time of onset, these patients are generally not offered thrombolytic therapy. Some of these wake-up stroke patients may be eligible for acute endovascular stroke therapy based on hyperacute CT or MR imaging independent of the time window. Report: We report two patients with acute ischemic stroke whose symptoms were present upon awakening and who were successfully treated with endovascular interventions. Results: The first patient was discharged with complete neurological recovery on second day after endovascular intervention. The second patient went home on fifth day with a mild left facial paresis and left arm drift. Both these patients did not he any neurological deficit on 18-month follow up. Conclusions: Some patients who present with stroke on awakening may be candidates for thrombolytic therapy or recanalization techniques irrespective of mode of therapy (intravenous, intravenous + intraarterial or intra-arterial tPA alone). Further randomized, controlled studies are warranted to safely identify those candidates who would benefit from thrombolysis and endovascular interventions in ischemic wake-up strokes. (C) 2010 Elsevier B.V. All rights reserved.
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Keywords
Neurosciences & Neurology
Citation
300 ,42767;148-150